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Apply for Office Coordinator

Hello and thank you for your interest in Home Instead. Please fill out the application below and click the Submit button when finished. Fields with an asterisk (*) are required.

Please note that this is the job board for the franchise office located at 421 S. Seguin Avenue, New Braunfels, TX 78130. Each Home Instead franchise is independently owned and operated. To find a franchise near you, please visit the Careers page.

For job related questions please call the franchise office at 830-624-8380.

Summary

Title:
Office Coordinator
ID:
1416
Contact Information

* First Name:

* Last Name:

* Address 1:

Address 2:

* City:

* State:

* Zip:

* Cell Phone:

* Email:

Opt-In Confirmation


I authorize recruiters from Home Instead 366 to send text messages from 8445312326 with requests for additional information in relation to this job application only. Message/data rates apply. Message frequency varies.
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Cover Letter:
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Additional Information
* How did you hear about Home Instead?

If applicable, please specify:

Key Player Application for Employment
APPLICANT NOTE
This application form is intended for use in evaluating your qualifications for employment with Manus Servientes of Texas Corporation, an independently owned and operated Home Instead franchise. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment begins, terminating employment. All qualified applicants will receive consideration and will be treated throughout their employment without regard to race, color, religion, sex, national origin, age, disability, creed or any other protected class status under applicable law.

Additional testing for the presence of illegal drugs in your body is required prior to employment. All employees of this Company are hired on an at-will basis, which means that either the employer or the employee may end the employment relationship at any time, for any legal reason or no reason at all. Only the owner is authorized to change this relationship on behalf of the Company and any such change may only be made in writing.

PERSONAL INFORMATION
Work Phone:
  Home Phone:
Alternate Phone:
  * Cell Phone:
Emergency Contact (Name/Phone/Relationship):
 
* Exp. Date:
  * State Issued:
 
  * In order to be able to provide transportation or run errands that would be among your duties, you will be required to have a valid driver’s license and current auto insurance. A motor vehicle record check will be conducted and proof of insurance will be required. Valid Driver’s License #:
* Make & Year of Vehicle:
 
Policy #:
  * Are you 19 years of age or older?:
Yes No

* Are you able to lift 25 pounds?:
 
Yes No
* Do you have reliable transportation?:
Yes No

* Have you ever submitted an application to this Home Instead location before?:
 
Yes No

If yes, when?:
 
* Have you ever been employed at this Home instead location before?:
 
Yes No

If yes, when?:
 
* Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accommodation?:
 
Yes No



EDUCATION
 
High School
Name & Location
*

Major Subjects

Did you Graduate?
If not, how many years
did you complete?

 
Vocational/Technical
Name & Location

Major Subjects

Did you Graduate?
If not, how many years
did you complete?

 
College/University
Name & Location

Major Subjects

Did you Graduate?
If not, how many years
did you complete?


WORK HISTORY
MOST RECENT EMPLOYER

* Are you currently working for this employer?:
 
Yes No

* If yes, may we contact?:
 
Yes No

* Company Name & Address (1):
 
* Company Phone (1):
 
* Dates Employed - From/To (1):
 
Job Title (1):
 
Supervisor's Name (1):
 
Duties (1):
 
Salary (1):
 
Reason for Leaving (1):
 
SECOND RECENT EMPLOYER

* Are you currently working for this employer?:
 
Yes No

* If yes, may we contact?:
 
Yes No

* Company Name & Address (2):
 
* Company Phone (2):
 
* Dates Employed - From/To (2):
 
Job Title (2):
 
Supervisor's Name (2):
 
Duties (2):
 
Salary (2):
 
Reason for Leaving (2):
 
THRID RECENT EMPLOYER

* Are you currently working for this employer?:
 
Yes No

* If yes, may we contact?:
 
Yes No

* Company Name & Address (3):
 
* Company Phone (3):
 
* Dates Employed - From/To (3):
 
Job Title (3):
 
Supervisor's Name (3):
 
Duties (3):
 
Salary (3):
 
Reason for Leaving (3):
 

BACKGROUND
As a condition of employment, all employees must be “Bondable” because from time to time an employee may be in the homes of the elderly or infirm. You must have a suitable criminal history background check and drug screen.

List states and counties of residence for the past seven (7) years:

* State/County (1):
 
State/County (2):
 
State/County (3):
 
State/County (4):
 

* Have you used any names (such as Maiden name) or social security numbers other than those listed on the application?:
 
Yes No

If so, please list:
 
* Have you had any moving traffic violations?:
 
Yes No

If yes, please describe:
 
* Have you been convicted of a felony or misdemeanor? (Conviction will not constitute an automatic bar to employment. The Company will consider the nature of the crime, its seriousness, the underlying conduct involved, the substantial relation to the functions and qualifications of the position being sought, the number of occurrences, the applicant’s age at the time of the crime, the time elapsed since the crime, the applicant’s entire work and educational history, employment references and recommendations, and the business necessity of any exclusion, if applicable.):
 
Yes No

If yes, please describe the incident, the city/state where occurred and the result.:
 

REFERENCES
If you are considered for a position, we may contact your references and would ask that you notify them in advance. Please do not list relatives or family/relations.

Professional References
Full Name
*

Phone Number
*

Best Time of
Day to Call
*
AM PM

Email
*

Relationship
*

Number of
Years
Known
*

Full Name
*

Phone Number
*

Best Time of
Day to Call
*
AM PM

Email
*

Relationship
*

Number of
Years
Known
*


Personal References
Full Name
*

Phone Number
*

Best Time of
Day to Call
*
AM PM

Email
*

Relationship
*

Number of
Years
Known
*

Full Name
*

Phone Number
*

Best Time of
Day to Call
*
AM PM

Email
*

Relationship
*

Number of
Years
Known
*


CERTIFICATION AND RELEASE
I certify that I have read and understand the applicant note on page one of this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief.

I understand that any false information, omissions or misrepresentations of facts in this application may result in rejection of my application or discharge at any time during my employment.

I authorize the company and/or its agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to, criminal history (including fingerprint-based) and motor vehicle driving records.

I authorize all persons, schools, companies and law enforcement authorities, health care worker registries to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information.

I release this company from any liability which might result from making such investigations. I also understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.

I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT. I ALSO UNDERSTAND THAT IF HIRED, REGARDLESS OF ANY ORAL REPRESENTATIONS TO THE CONTRARY, THE EMPLOYMENT RELATIONSHIP BETWEEN ME AND Hill Country Senior Services LLC IS TERMINABLE AT-WILL, SO THAT BOTH THE COMPANY AND I REMAIN FREE TO CHOOSE TO END OUR WORK RELATIONSHIP AT ANY TIME FOR ANY OR NO REASON. ANY CHANGES IN THIS EMPLOYMENT RELATIONSHIP MUST BE MADE IN WRITING.

By typing your name below you are electronically signing this document.

* Signature (type name):

* Date:


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New Braunfels, Seguin, San Marcos
421 S Seguin Ave
New Braunfels, TX 78130
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(830) 624-8380
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Each Home Instead franchise office is independently owned and operated.
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